Can You Die From Sleep Apnea?

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Can Sleep Apnea Cause Death?

Sleep apnea refers to a sleep disorder in which people have reductions or pauses in breathing during sleep. These repeated breathing disruptions can reduce sleep quality and contribute to serious health complications. Although treatment often resolves health risks tied to sleep apnea, if left unaddressed, sleep apnea can be a life-threatening problem.

Sleep apnea can cause death indirectly, but it’s rarely a direct cause of death. Obstructive sleep apnea (OSA) has many comorbidities, Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source or other conditions that exist alongside sleep apnea, including serious ones like heart disease, atrial fibrillation (AFib), obesity, diabetes, and hypertension. People with OSA also have an increased risk of depression and accidents related to sleeplessness. 

It’s possible, but rare, to die from a single apneatic event where you stop breathing and your body doesn’t recover. More often, OSA is a contributor to fatal conditions, and it makes them worse. Repeated pauses in breathing stress your cardiovascular system and deprive you of oxygen, which can make serious heart and breathing conditions more severe. Researchers have found that OSA has major associations with cardiac arrest. Trusted Source Cureus Journal of Medical ScienceView Source

So, while it’s unlikely to die from an OSA-related breathing pause, OSA can certainly worsen serious conditions that can lead to death. 

Obstructive Sleep Apnea and the Risk of Death

OSA is the most common type of sleep apnea and affects between 10% and 30% Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source of American adults. Multiple research studies have shown that people with OSA have a higher risk of all-cause mortality, which means that they’re more likely to die of any cause when compared to people who don’t have OSA. Untreated OSA has also been linked to an increased risk of death Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source from cardiovascular problems.

Research suggests that the risk of mortality in people with sleep apnea may be connected to the severity of their breathing disruptions. Doctors classify the severity of OSA based on a person’s symptoms and their apnea-hypopnea index (AHI), which is calculated based on the number of breathing disruptions that occur during an hour of sleep. The risk of all-cause mortality has been found to be higher in people with more severe OSA Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source .

Central Sleep Apnea and the Risk of Death

Central sleep apnea (CSA) is much less common than OSA, and there are fewer studies about its effect on the risk of death. CSA involves an inability of the brain and respiratory muscles to properly regulate breathing and is frequently linked to underlying health problems Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source , such as heart failure, that may affect a person’s expected lifespan.

In people with heart failure, having severe CSA has been connected to a higher risk of death Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source . The risk of sudden death may be higher in people with severe CSA and heart failure because of the way that CSA can interfere with cardiovascular function.

For some people, treating the underlying cause of CSA can reduce or resolve breathing problems during sleep. Reestablishing normal breathing patterns may help enhance sleep quality and reduce other symptoms and complications of CSA.

What Are the Risks of Untreated Sleep Apnea?

Obstructive sleep apnea occurs when the upper airway becomes blocked by tissues in the mouth and throat. Obstructions to breathing can negatively affect health by influencing a person’s risk of several complications.

• Accidents: People with OSA get lower quality sleep, leading to daytime sleepiness and lack of concentration that makes them prone to accidents. Drowsy driving is more common in people with OSA, which can make potentially fatal car crashes more likely.
• Cardiovascular disease: The effects of OSA on the body are often seen in the cardiovascular system. For example, people with untreated OSA have been found to be more likely to have an abnormal heart rate, high blood pressure, heart attack, stroke, heart disease, and pulmonary hypertension.
• Type 2 diabetes: OSA can disrupt how the body manages blood sugar levels, raising the risk of type 2 diabetes, a condition that can cause a wide range of further health problems.
• Problems after surgery: People with OSA are more likely to have unintended postoperative side effects, including complications that can be life-threatening.
• Liver disease: Rates of nonalcoholic fatty liver disease are as many as three times as high in people with OSA. While not always linked to complications Trusted Source Medline PlusMedlinePlus is an online health information resource for patients and their families and friends.View Source , this condition can cause liver damage, liver cancer, and ultimately liver failure.

Can You Die in Your Sleep From Sleep Apnea?

Although uncommon, it’s possible to die during sleep from obstructive sleep apnea. Sudden deaths are usually tied to one of the following factors: Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source severe OSA, low oxygen levels, Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source or heart rhythm problems. Observational research has found that having OSA increases a person’s risk of sudden death. 

When OSA isn’t treated, it can interfere with the normal functions of the cardiovascular and nervous systems. This may provoke abnormalities in a person’s heart rhythms and other problems that can cause sudden cardiac death. When your brain doesn’t get enough oxygen, death from stroke also becomes a risk.

Most of the time, pauses in breathing from obstructive sleep apnea are just temporary. When changes in respiration cause oxygen levels to drop, a person partially awakens in order to restore breathing. However, there are rare reports of people dying because of an inability to properly reinitiate breathing.

How Common Is Death From Sleep Apnea?

Sleep apnea-related deaths are on the rise, especially among men, Black men, and people in the Midwest, according to researchers. Trusted Source ChestView Source  

That said, sleep apnea is more likely to be a factor that contributes to death, rather than a direct cause of death. People with sleep apnea are three times more likely to die from any cause than people without the disorder. Trusted Source American Academy of Sleep Medicine (AASM)AASM sets standards and promotes excellence in sleep medicine health care, education, and research.View Source Those with untreated sleep apnea are at even higher risk.

This risk increases with OSA severity and existing comorbidities. People with high AHI scores stop breathing often, which deprives their brains of oxygen. When your brain lacks oxygen, your body is more likely to have cardiovascular issues and strokes. 

Because sleep apnea is a factor in so many other serious conditions and it often goes undiagnosed, it’s hard to pinpoint exactly how many people die from the disorder. One review of the Centers for Disease Control and Prevention (CDC) data shows that between 1999 and 2020, more than 230,000 people in the U.S. had sleep apnea-associated deaths.

Who Is Most at Risk?

People with severe OSA, existing comorbidities, untreated OSA, and older adults are at most risk of sleep apnea-related death. 

Low oxygen levels impact brain and cardiovascular function, which puts people with high AHI scores in a dangerous zone. If people with OSA aren’t treating their sleep apnea with CPAP therapy or an alternative, they aren’t getting the proper amount of oxygen to prevent apneatic events and decreased oxygen levels. 

Older adults, especially those with daytime sleepiness, are at risk of death from sleep apnea. Trusted Source American Academy of Sleep Medicine (AASM)AASM sets standards and promotes excellence in sleep medicine health care, education, and research.View Source Further studies are needed to determine exactly why, but comorbidities like heart disease and stroke could be factors. 

Does Treating Sleep Apnea Reduce Risk?

Treatment can often eliminate or decrease OSA-related breathing and sleep disruptions. As a result, people who are effectively treated for OSA can avoid the heightened risk of complications and death linked to untreated OSA.

As an initial treatment of OSA, doctors often prescribed the use of a continuous positive airway pressure (CPAP) machine. A CPAP device sends pressurized air through a hose and mask to keep the upper airway open during sleep.

A study involving over 88,000 people Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source compared health outcomes in people with OSA who started and continued using a CPAP machine versus people who started with a CPAP device but then stopped using it. Ongoing use of the CPAP device was associated with a significant decrease in the risk of all-cause mortality.

In the same study, the benefits of CPAP therapy were seen at follow-up after one year and after three years. Other research over a period of up to seven years also found a lower risk of death in people with OSA who regularly used a CPAP machine.

In order to effectively treat OSA with CPAP therapy, it’s important to use the CPAP regularly. In general, this means wearing the CPAP for at least four hours per night on five or more nights of the week. Doctors and sleep specialists can work with people having difficulties tolerating CPAP by modifying the settings and accessories for CPAP therapy.

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When to See a Doctor

Recognizing the signs of sleep apnea can help people know when to contact their doctor. Some of the most common signs and symptoms of sleep apnea include:

• Excessive daytime sleepiness, including falling asleep during times when it is normal to be awake
• Frequent snoring that is very loud
• Irregular breathing, including gasping or choking, during sleep
• Morning headaches
• Waking up with a sore throat or dry mouth
• Struggling with concentration or memory during the day
• Feeling unrefreshed despite sleeping for seven hours or more

People with the above symptoms should talk with their primary care doctor. The doctor can review their symptoms, sleep patterns, and overall health and recommend testing with a sleep study if necessary.

It’s important to remember that it’s not possible to diagnose sleep apnea based only on a person’s symptoms. Symptoms of sleep apnea can also be caused by other health issues, so diagnostic testing is required to determine if a person’s symptoms are caused by sleep apnea. Sleep tests can be done both in a sleep clinic and at home. 

People who have already been diagnosed with sleep apnea should talk with their doctor or a sleep specialist if they have problems sticking with their treatment, have unwanted side effects of treatment, or find that treatment is not reducing their symptoms.

While untreated sleep apnea is associated with potentially life-threatening complications, working with a medical professional and closely following treatment recommendations can resolve many of these health risks.

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